Derek Cantu
N342-Mental Health
Mental Health Journal (3/4/2016)
The last clinical rotation for mental health at Methodist Specialty and Transplant Hospital involved being on the Acute Level II and Chemical and Drug Control floor. Nursing students that were assigned to this floor included Kenzie Cunningham, Michael Davis, and myself. On this particular day, Michael and I were working on the Level II Acute Care floor while Kenzie was on the Chemical and Drug Dependent side. Compared to the previous rotation on this floor, this clinical was a lot different and we got to experience what exactly the registered nurse’s role is in mental health. I sat in on one group therapy and a few discussions that took place while at the Methodist Specialty and Transplant Hospital. All these items took place on the sixth floor of the hospital in the units mentioned above. Also, it occurred during our rotation on March 4, 2016 starting at 0700. The day consisted of us being assigned to a registered nurse and following them all clinical to experience the life of a mental health nurse.
Like mentioned in the introduction, the last time we were on this floor, the nurses were not as involved with us like they had been before. The charge nurse was a lot friendlier and engaged so much more with us than she had ever while being at Methodist Specialty and Transplant. She asked us what we wanted to do after nursing school and basically communicated with us the whole time. The other nurses also engaged with us making the clinical experience so much more enjoyable. I was assigned to a nurse on the Acute Level II floor who also worked as a charge nurse occasionally. One particular thing that I noticed on this day was the patients were a lot more provocative and needy than the last time I was on the sixth floor. The day started by the nurse and I making rounds and almost all patients were asking or complaining about something that they did not like. Every patient needed something in particular and I knew at that point that it was going to be a long clinical shift. Even though we did not stay busy for most of the morning, it was enough to keep me intrigued. Today, I recognized the RN role when the charge nurse assigned us to nurses and we were able to observe all they did. The role of an RN in a mental health facility is to be observant of their patients, to monitor their mental status, and give them medications as needed or prescribed. The nurse I was assigned to for the day was very helpful in showing me their nursing care plans and how they document their notes into the computer. One thing she showed me is how they have plan of care saved for all the different nursing diagnosis which helps saves them a lot of time when working on the nursing care plan. She went over all the regulations they were required to maintain and deal with on a regular basis. A positive aspect I discovered with this nurse was that the patients knew who she was and showed a genuine interest in her as their nurse. One encounter I found interesting was when one of the patients told her about the night staff nurses. This one patient was not pleased with the night crew staff nurses and voiced her opinion to the RN I was following on Friday. Something to take into consideration on this particular matter was the validity of the situation and how much was the patient telling the truth. Even though the night nurses may have been rude or inappropriate, one still must reconsider until the night nurses can tell their story as well. Another positive experience was when one of the patients that was there two weeks ago was still there but was being discharge on this day of clinical rotation. The patient had been receiving ECT which seemed to be helping her tremendously. The RN had made a comment that that was the first time she had seen that particular patient smile. I saw the patient two weeks ago and to see her again after those two weeks was a completely different outlook by her. She seemed to be more attentive and aware of her lifestyle. There was definitely improvement from the previous week when I was on the floor. Also I got to attend a flash session which was a unique experience as well. It was interesting to see all the doctors and staff come together to hear the progress on their patients. I will say that this clinical made me feel the best while being at this rotation because everybody was much more opened and helped us out. The charge nurse was completely different which was a huge benefit. The day on the floor was very helpful in being able to diagnose the role of a mental health RN.
When looking back I recognize that today involved much more interaction with the nurses on the floor and the staff involved on the clinical day. Being able to follow the RN was a benefit when trying to understand the role of an RN involved with mental health. Most of the events that took place today were beneficial, but I do not see myself going into mental health. There is not enough movement for me and the nurses stay in their stations for most of the day. The things I learned today have taught me to always get involved with my patients because you may not think about it sometimes, but the patients do remember who you are and how you helped them. After the clinical from this week, I felt like some of the nurses needed to see how the younger ones worked because they were a lot more passionate than those that have worked for a couple years. Being able to see the improvement in that one patient that was being discharged was really a good feeling to know she was getting another chance. She did not remember from the last time I was there but I do remember how she was completely different. Also another reflection I found interesting was that the hospital was about to implement a program where all their medical techs will have to be trained in mental health as well. The nurses and techs did not like this and I found it very interesting based off the other techs opinions. The techs stated how they would not be able to handle patients on the medical floor since that is not their area of specialty. Their concern was that they would not know how to handle a situation on the medical floor and how medical techs would not be able to handle a situation on the mental health floor. Overall, the analysis for today was pretty good and was much more beneficial than the last time I was up on the floor.
The knowledge I gained from today was being able to monitor your patients on a day to day basis. It is critical to be able to apply this simply because the more you know about your patients could end up saving the patient’s life one day. When one knows the improvement of their patient then it helps them prioritize the order in which they should take care of their patients. This will be something I use on a day to day basis especially if I do receive my DNP. I will be seeing multiple patients a day depending on my field of study and will have to be able to recognize and remember what I might have implemented the day before. Also, during flash the nurse provided everything accurately and appropriately which will be something I have to do with a doctor one day. I will need to know all the information on the patient in order to give quick and concise information to the doctor. The day involved a lot of learning that I will continue to implement as I further my knowledge and implementation in nursing. Overall, I will have to be observant as a nurse and do all I can in order to help my patient get better and back to being healthy. The tasks I learned and saw today will be used multiple times in my career and being able to see how nurses handle it now helps me get a jumpstart and ways to improve it myself.